South Side Drug Co., Inc.

Primary specialty

PharmacyTaxonomy code 333600000X

License

1150 Issued in TN

Legal business name

SOUTH SIDE DRUG CO., INC.

Doing business as

South Side Clinical Services

Practice address

1000 S Main St
Springfield, TN 37172-3508

Phone

(615) 384-3546

NPI assigned

Oct 17, 2016

Last updated

Nov 18, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Don SloanNPI 1023186335

Title

President/Owner

Phone

(615) 384-3546

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• South Side Clinical Services Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• South Side Drug Co Inc

  • Community/Retail Pharmacy
  • Springfield, TN
  • NPI 1649312737

  O20071115000074

  Same enrollment

Tax ID family

South Side Drug Co Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• South Side Drug Co Inc

  • Community/Retail Pharmacy
  • Springfield, TN
  • NPI 1649312737
  NPD tax ID
• South Side Pharmacy, Inc.

  dba South Side Drug Co., INC.

  • Long Term Care Pharmacy
  • Springfield, TN
  • NPI 1548911498
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Don R Sloan

  • Pharmacist
  • Springfield, TN
  • NPI 1023186335
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479427200000",
    "number": "1578014452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 S MAIN ST",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "371723508",
            "telephone_number": "615-384-3546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S MAIN ST",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "371723508",
            "telephone_number": "615-384-3546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SIDE DRUG CO., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-17",
        "last_updated": "2016-11-18",
        "status": "A",
        "authorized_official_last_name": "SLOAN",
        "authorized_official_first_name": "DON",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "615-384-3546"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TN",
            "license": "1150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1455170",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Side Clinical Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thomas Smith, APRN
• Ethan Snider
• Jana Plant Socey, OD
• Sono Pro, LLC
• South Side Drug Co Inc
• South Side Pharmacy, Inc. (South Side Drug Co., INC.)
• Stephanie Spann, MCD, CFY, SLP
• Suzanne Glover Spicer, M.D.
• Springfield Health Services, LLC (NorthCrest Medical Center)
• Springfield Health Services, LLC (NorthCrest Medical Center)

• Pharmacy in Springfield, TN
• Providers in Springfield, TN by specialty
• Pharmacy in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.